Skip to main content
Log in

Quantitation of Human Immunodeficiency Virus Type 1 RNA Loads in Cervicovaginal Secretions in Pregnant Women and Relationship Between Viral Loads in the Genital Tract and Blood

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

The purpose of this study was to analyze the quantitation of the human immunodeficiency virus type 1 RNA (HIV-1 RNA) in the genital tract of HIV-1-infected pregnant women and to evaluate a possible correlation with the viral load in blood plasma (Spearman’s rank correlation coefficient). A total of 38 each of cervical, vaginal, and blood samples from 38 women were obtained during the third trimester of pregnancy for quantitation of the HIV-1 RNA load. Viral loads were determined by reverse transcription-polymerase chain reaction. The HIV-1 RNA viral load was detectable in 29 of the 38 (76.3%) blood samples, in 6 of the 38 (15.7%) cervical secretion samples, and in 8 of the 38 (21%) vaginal secretion samples. Overall, the correlation between the HIV-1 RNA viral load in the blood plasma and in cervical secretion samples was 0.51 (P<0.001). However, the correlation disappeared (r=0.27) when three patients with high blood plasma viral loads were eliminated from the statistical study. The viral load in the vaginal secretions did not correlate with that in the blood samples (r=0.26). There were two cases in which HIV-1 RNA was undetectable in the blood and cervix but was detectable in vaginal secretions: one woman had 220 copies/ml and the other 68 copies/ml. These results suggest that pregnant women with undetectable viral loads in blood plasma are still at risk of transmitting the virus vertically during vaginal delivery. Because of this, antiretroviral prophylaxis during vaginal delivery must be administered to HIV-1-infected women and their newborns, regardless of the mother’s viral load in plasma. In conclusion, quantification of cervicovaginal levels of HIV-1 may represent a useful tool for assessing the individual risk associated with a vaginal delivery and for guiding decisions about whether a scheduled caesarean should be recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Loussert-Ajaka I, Mandelbrot L, Delmas MC, Bastian H, Benifla JL, Farfara I, De Vincenzi I, Matheron S, Simon F, Brun-Vezinet F (1997) HIV-1 detection in cervicovaginal secretions during pregnancy. AIDS 11:1575–1581

    CAS  PubMed  Google Scholar 

  2. Gaillard P, Verhofstede C, Mwanyumba F, Claeys P, Chohan V, Mandaliya K, Bwayo J, Plum J, Temmerman M (2000) Exposure to HIV-1 during delivery and mother-to-child transmission. AIDS 14:2341–2348

    Article  CAS  PubMed  Google Scholar 

  3. Iversen AKN, Larsen AR, Jensen T, Fugger L, Balslev U, Wahl S, Gerstoft J, Mullins JI, Skinhoj P (1998) Distinct determinants of human immunodeficiency virus type 1 RNA and DNA loads in vaginal and cervical secretions. J Infect Dis 177:1214–1220

    CAS  PubMed  Google Scholar 

  4. Hart CE, Lennox JL, Pratt-Palmore M, Wright TC, Schinazi RF, Evans-Strickfaden TE, Bush TJ, Schenell C, Conley LJ, Clancy KA, Ellerbrock TV (1999) Correlation of human immunodeficiency virus type 1 RNA levels in blood and the female genital tract. J Infect Dis 179:871–882

    Article  CAS  PubMed  Google Scholar 

  5. Debiaggi M, Zara F, Spinillo A, De Santolo A, Maserati R, Bruno R, Sacchi P, Achilli G, Pistorio A, Romero E, Filice G (2001) Viral excretion in cervicovaginal secretions of HIV-1 infected women receiving antiretroviral therapy. Eur J Clin Microbiol Infect Dis 20:91–96

    Article  CAS  PubMed  Google Scholar 

  6. Kovacs A, Chan LS, Chen ZC, Meyer WA, Muderspach L, Young M, Anastos K, Levine AM (1999) HIV-1 RNA in plasma and genital tract secretions in women infected with HIV-1. J Acquir Immune Defic Syndr 22:124–131

    CAS  PubMed  Google Scholar 

  7. Rasheed S, Li Z, Xu D, Kovacs A (1996) Presence of cell-free human immunodeficiency virus in cervicovaginal secretions is independent of viral load in the blood of human immunodeficiency virus-infected women. Am J Obstet Gynecol 175:122–130

    CAS  PubMed  Google Scholar 

  8. Shaheen F, Sison AV, McIntosh L, Mukhart M, Pomerantz RJ (1999) Analysis of HIV-1 in the cervicovaginal secretions and blood of pregnant and nonpregnant women. J Hum Virol 2:154–166

    CAS  PubMed  Google Scholar 

  9. Chuachoowong R, Shaffer N, Siriwasin W, Chaisilwattana P, Young NL, Mock PA, Chearskul S, Waranawat N, Chaowanachan T, Karon J, Simonds RJ, Mastro TD (2000) Short-course antenatal zidovudine reduces both cervicovaginal human immunodeficiency virus type 1 RNA levels and risk of perinatal transmission. J Infect Dis 181:99–106

    CAS  PubMed  Google Scholar 

  10. Si-Mohamed A, Andreoletti L, Colombet I, Carreno MP, López G, Chatelier G, Kazatchkin MD, Belec L (2001) Quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in cell-free cervicovaginal secretions: comparison of reverse transcription-PCR amplification (AMPLICOR HIV-1 MONITOR 1.5) with enhanced-sensitivity branched-DNA assay (Quantiplex 3.0). J Clin Microbiol 39:2055–2059

    Article  CAS  PubMed  Google Scholar 

  11. The European Collaborative Study (1997) Maternal viral load and vertical transmission of HIV-1: an important factor but not the only one. AIDS 13:1377–1385

    Google Scholar 

  12. García PM, Kalish LA, Pitt J, Minkoff H, Quinn TC, Burchett SK, Kornegail J, Jackon B, Moye J, Hanson C, Zorrilla C, Lew JF (1999) Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. N Engl J Med 341:394–402

    Article  PubMed  Google Scholar 

  13. Henin Y, Mandelbrot L, Henrion R, Pradinaud R, Coulaud JP, Montagnier L (1993) Virus excretion in the cervicovaginal secretions of pregnant and non-pregnant HIV-infected women. J Acquir Immune Defic Syndr 6:7275

    Google Scholar 

  14. Kovacs A, Wasserman SS, Burns D, Wright DJ, Cohn J, Landay A, et al (2001) Determinants of HIV-1 shedding in the genital tract of women. Lancet 358:1593–1601

    Article  CAS  PubMed  Google Scholar 

  15. Taylor S, Sadiq T, Sabin C, White D, Cane P, Drake S, Pillay D (2003) Seminal super shedding of HIV: implications for sexual transmission. In: Program and abstracts of the 10th Conference on Retroviruses and Opportunistic Infections, Boston, Abstract no. 454

  16. Lennox J, Ellerbrock T, Bush T, Conley L, Evans-Strickfaden T, Hart C (2003) Subclinical inflammation in the female genital tract is strongly associated with vaginal viral shedding independent of plasma viral load. In: Program and abstracts of the 10th Conference on Retroviruses and Opportunistic Infections, Boston, Abstract no. 101

  17. Iribarren JA, Ramos JR, Guerra L, Coll O, De José MI, Domingo P, Fortuny C, Miralles P, Parras F, Peña JM, Rodrigo C, Vidal R (2001) Prevención de la transmisión vertical y tratamiento de la infección por el virus de la inmunodeficiencia humana en la mujer embarazada. Enferm Infecc Microbiol Clin 19:314–335

    CAS  PubMed  Google Scholar 

  18. Centers for Disease Control and Prevention (2003) US Public Health Service Task Force. Recommendations for use of antiretroviral drugs in pregnant HIV-1 infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States. Disposable in http://www.hivatis.org. Cited September 22, 2003

Download references

Acknowledgements

This work was funded by a grant from “Fundación para la Investigación y Prevención del SIDA” and performed in the frame of Red Temática Cooperativa de Investigación En SIDA (G03/173) del Fisss. We would like to acknowledge the help we received from Dr. Madero and Dr. Gracia for statistical data analysis.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Ladrón de Guevara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

García-Bujalance, S., Ruiz, G., de Guevara, C.L. et al. Quantitation of Human Immunodeficiency Virus Type 1 RNA Loads in Cervicovaginal Secretions in Pregnant Women and Relationship Between Viral Loads in the Genital Tract and Blood. Eur J Clin Microbiol Infect Dis 23, 111–115 (2004). https://doi.org/10.1007/s10096-003-1058-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-003-1058-4

Keywords

Navigation